The decision to enter a medical specialty: Timing and stability

Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, Chicago, Illinois 60611.
Medical Education (Impact Factor: 3.2). 08/1992; 26(4):327-32. DOI: 10.1111/j.1365-2923.1992.tb00177.x
Source: PubMed


The timing and stability of the decision to enter a medical specialty were examined for one class of medical students. Students were asked to predict specialty choices for themselves on six occasions from orientation day in year 1 to January of the senior year. Choices were compared to actual National Residency Matching Programme results. Forty-five per cent predicted their ultimate specialty choice at orientation, and 69% predicted their ultimate choice by the end of the second year. Specialty choices are made early, and are more stable and accurate than the previous literature has suggested. Variations in timing among the specialties are described, and implications for medical education are discussed.

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    • "These career intentions have been shown to predict choice of practice [27] [28] which lends importance to factors which contribute to that early influence such as status or prestige [29]. The relevance is highlighted by findings that 45% of students adhere to their broad career preference indicated at entry to medical school [27] and that the most powerful predictors of a rural place of practice are rural origin combined with an intention to practice as a generalist on entry to medical school [12]. Prestige is known to be a more significant consideration for males, students of higher socioeconomic parents, and students of Asian origin [30] [31] [32]. "
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    ABSTRACT: Introduction. In 2000, the Dunedin School of Medicine (one of Otago Medical School's 3 clinical schools) introduced 7-week rural placement. A survey of students conducted before attending the placement showed that most students did not perceive faculty to have a positive view of rural health. In 2007, we explored whether students' perceptions had changed. Method. All 5th year medical students at Otago Medical School were surveyed using items from the original study. The perceptions of students in Dunedin were compared with those of students in the other clinical schools (no rural rotation) and with those of students in the original study. Results. In 2007, there was a significantly increased likelihood of students from Dunedin reporting perceptions of positive faculty attitudes towards rural health compared with students from the other two clinical schools and with Dunedin students from the original survey. Conclusion. The results suggest that student perceptions of faculty attitudes in the school towards rural health may be changed following the introduction of a general practice rural placement to its curriculum.
    Full-text · Article · Aug 2014
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    • "They also noted that many students make postgraduate specialty decisions early in their third year of medical school. A U.S. study found that 69% of medical students chose their specialty at the end of second year.(10) Regardless of specialty choice, improving attitudes towards geriatrics is important in caring for the aging population. "
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    ABSTRACT: The aging population requires an improvement in physicians' attitudes, knowledge, and skills, regardless of their specialty. This study aimed to identify attitude changes of University of Toronto pre-clerkship medical students towards geriatrics after participation in a Geriatric Clinical Skills Day (GCSD). This was a before and after study. The GCSD consisted of one large and four small interactive, inter-professional geriatric medicine workshops facilitated by various health professionals. A questionnaire, including the validated UCLA Geriatrics Attitudes Scale, was administered to participating pre-clerkship medical students before and after the GCSD. A one-sample t-test and signed rank parametric test were used to determine attitude changes. 42.1% indicated an interest in Geriatric Medicine, 26.3% in Geriatric Psychiatry, and 63.2% in working with elderly patients. Both pre- and post-mean scores were greater than 3 (neutral), indicating a positive attitude before and after the intervention (p < .001). There was no significant difference in the change in mean total scores (signed rank test p ≥ .12, Student's t-test p > .11). The GCSD did not alter pre-clerkship students' attitudes towards geriatrics. This study adds to geriatric medical education research and warrants further investigation in a larger, multi-centred trial.
    Full-text · Article · Mar 2014
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    • "Many researchers have demonstrated that career preferences at the time of entering medical school may be a significant predictor of students’ eventual careers and that many students end up in careers that are closely related to their choice of specialty at the beginning of medical school. Thus it is very important to define the factors that affect career specialty in the early years of medical school [7,8]. Career counselling would identify the students’ inclination early and guide them to careers most suitable for them. "
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    ABSTRACT: Background Understanding preferences for specialties by medical students and the factors driving choices assists policy makers in ensuring optimal spread of personnel across disciplines. Methods This cross-sectional survey using self-administered structured questionnaires was conducted on consenting students of the first medical school in The Gambia, established in 1999. Data collection was in June/July 2011. Questions were on sociodemographic characteristics of students, their parents, factors related to career preferences and opinions about counseling services. Data were analysed using JMP 8.0 software. Results Respondents were 52.4% of 202 eligible students. Mean age was 24.1 ± 5.0 years. Females constituted 54.7%. Muslims were 72.7% while Gambians formed 77.0%. Commonest specialties chosen by females were Obstetrics/Gynaecology, Paediatrics and Surgery in that order, while males preferred Internal Medicine, Surgery and Obstetrics/Gynaecology. Commonest factors influencing choices by females were ‘focus on urgent care’ (65.5%) and ‘intellectual content of specialty’ (56.9%). For males, these were ‘intellectual content of specialty’ (60.4%) and ‘focus on urgent care’ / ‘individual’s competence’ (50.0% each). More females (30.0%) than males (23.0%) had ever received career counseling, but all students desired it. Conclusions Significant gender differences exist in specialty choices and factors influencing these choices amongst these students. All want career counseling.
    Full-text · Article · Aug 2012 · BMC Medical Education
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